Columns, COVID-19: Inside the Global Epicenter
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Reflections from the COVID Service

by Dr. Ritu Nahar, MD, internal medicine resident physician in Philadelphia, Pennsylvania, written for COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers by Krutika Parasar Raulkar, MD 

Prior to starting the COVID service, I was eating and drinking fear and anxiety — there were wakeless nights and internet research, scrutinizing countless emails taking notes on the latest Jefferson COVID guidelines. I was alternating between feeling like a strong and resilient knight in the face of this mysterious and ferocious virus, to an imposter knight cowardly fearing the impending doom while basking in the existing gloom.

Upon starting the service, the anxiety within the hospital was physically and psychologically palpable. As the routine of being on the COVID service began to normalize, I quickly realized there was actually little we could offer patients. I now dug for the courage to face my sense of powerlessness as I admitted repeatedly to patients and their family how little we could offer. I felt like I was on a palliative care rotation my first week, just making everyone DNR/DNI watching them perish on nonrebreathers.

But there were those that made it! The few that persevered. The 90-year-old sassy lady who still drove her daughter home from the Bronx, where she worked as a nurse (also COVID positive). But there were days that broke me. I remember the fatigue as I consciously chose not to go visit Mr. P’s wife and family when they came to say their final goodbyes.

I’d read the news and feel rage towards those not following the social distancing protocols. I felt betrayed by the government who chose to ignore warnings of scientists for which our nation now stood woefully unprepared against this pandemic. Because even after I left the hospital, I couldn’t escape it. The virus was a silent stalker. It could be on my shoes, on my clothes, in my hair. Even as I took precautions stripping down at the door, showering what felt like an inordinate number of times I felt isolated and consumed by the unknown risk I carried of getting this goddamn virus or carrying it asymptomatically. I felt isolated from my family, from my boyfriend, and my roommate. This was a pretty significant disruption to my social support and there was no defined end date.

And I am now off the service, still feeling fatigued and anxious. I know I am an anxious person. This has been a lifelong struggle. But I reflect on my weeks and find myself saying, “It wasn’t even that bad.” I had an awesome team, and I was able to do my part. I feel healthy. Then why do I still feel so uneasy? Maybe because I start the ICU with COVID-positive patients again. Maybe it’s my selfish anxiety. After seeing what has happened to my patients and my friends. The implications of what could happen to my direct family. My friend’s dad passed of a sudden myocardial infarction, COVID-positive. My family member is in the ICU on ECMO, COVID-positive. My mom is going to the hospital to scope COVID-positive patients. My grandparents are in India — is this lockdown doing to be enough to protect them all?

I had been trying to cope by just being indifferent. By trying to keep busy. But that is a façade, as my underlying anxiety slowly leeches my energy while I attempt to rejuvenate in my face mask listening to Alt-J. They say no one will protect your suffering. I’m hoping writing this out will allow me to acknowledge the impact this experience has had and is having on me. I’m accepting this experience is pretty fucking shitty and the impact is magnitudes far beyond me. But I think in the midst of all this, I am allowing my anxiety of the morbid possibilities, of the things I can’t control, squelch my ability to stay connected with myself and others and maintain a sense of inner peace. It’s like nature was observing our society from afar and now has made her presence known, bringing us to our knees making us question — what really matters to you? I can choose to indulge in my anxiety or just surrender to the suffering this has and will cause while doing my part.

When I ask myself how I will I go on, I’m reminded of this quote from Sheryl Strayed:

“You go on by doing the best you can. You go on by being generous. You go on by being true. You go on by offering comfort to others who can’t go on. You go on by allowing the unbearable days to pass and allowing the pleasure in other days. You go on by finding a channel for your love and another for your rage.”

In her book COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers, Dr. Raulkar shares insider accounts of the deadly pandemic from one of the hardest hit medical systems in the world. Packed with the most current medical information, a historical account of the discovery and political reaction to COVID-19, and inspiring accounts and photos of frontline health care workers, this book provides the knowledge you need to stay well-informed about COVID-19, and hope and optimism to get you through these challenging times.

Krutika Parasar Raulkar, MD Krutika Parasar Raulkar, MD (4 Posts)

Attending Physician Guest Writer

NewYork-Presbyterian Columbia/Cornell

Krutika Parasar Raulkar completed her Physical Medicine and Rehabilitation residency at NewYork-Presbyterian/Columbia/Cornell, where she served during the pandemic. She graduated magna cum laude from Brown University in 2012 and attended Rutgers Robert Wood Johnson Medical School, where she was elected to the Gold Humanism Honor Society and received distinctions in Medical Education and Community Service. An exercise enthusiast, she has run three marathons and enjoys a myriad of sports/fitness activities. Her first book, Exercise as Medicine, was published by Wild Brilliance Press in 2018. The same year, Dr. Raulkar was featured on the Dr. Oz show for her care of Montel Williams after he suffered a stroke and received rehabilitation at Weill Cornell Medical Center. Following residency, Dr. Raulkar moved to Chapel Hill, North Carolina, where she lives with her husband and children, her lifelong partners in health and happiness.

In 2020, she published her second book, COVID-19: Inside the Global Epicenter, featuring New York City health care providers’ experiences from the peak of the pandemic.